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Humanitarianism

Aspects of international humanitarian law, refugee law, & human rights law relevant to mental health delivery in diverse settings

The Sphere project is a manual assembled and updated by multiple international groups and humanitarian aid organizations, with “concrete measurable benchmarks” (The Sphere Project, 2011) to outline quality, accountability, and values for humanitarian agencies, developed after mistakes from humanitarian groups during the Rwandan genocide. The Sphere has been updated to include four primary essential rights for all, and to guide the actions of humanitarians.  These are:

  1. Enhance the safety, dignity and rights of people, and avoid exposing them to harm.
  2. Ensure people’s access to assistance according to need and without discrimination.
  3. Assist people to recover from the physical and psychological effects of threatened or actual violence, coercion or deliberate deprivation.
  4. Help people claim their rights (Sphere Handbook, 2018, p.33)

In a TEDGlobal talk with António Guterres (2015), the impacts on Syrian refugees and on the communities they are fleeing to are discussed through the lens of how global policies affect human rights and suffering. The needs of Syrian refugees are exacerbated when surrounding countries taking them in, like Lebanon and Jordan, do not have the resources and also do not qualify for additional funding from sources such as the World Bank, as they are middle-income countries. These countries are then unable to provide enough support for the refugees.

As a global community, we should be supporting these countries as the front lines of defense and in supporting our collective international humanitarian commitment to refugees. Additionally, we should not be limiting how many refugees we can take in each country, as it is our duty to adjust our own society to meet the need.  Fear over security causes leaders to make harmful statements, such as Trump stating he would not allow any Muslim refugees in the US. However, statements like these actually provide fodder and support for terrorists, particularly Muslims who already reside in the US who are then ostracized and see themselves as needing to assert themselves and fight back against such statements, and so join terrorist groups. Refugees endure severe suffering, or else they would not be refugees in the first place – but then continue to be exposed to the worst conditions, unable to work, dependent on social support but often ineligible for it, health conditions and lack of medical care, and tensions with locals. 

              In the Nobel Prize acceptance speech by Medicins Sans Frontiers (MSF), also known as Doctors without Borders (Orbinski, 2000), they state “[h]umanitarian action is more than simple generosity, simple charity. It aims to build spaces of normalcy in the midst of what is profoundly abnormal. More than offering material assistance, we aim to enable individuals to regain their rights and dignity as human beings…Our action and our voice is an act of indignation, a refusal to accept an active or passive assault on the other.”

They also state “[h]umanitarianism occurs where the political has failed or is in crisis. We act not to assume political responsibility, but firstly to relieve the inhuman suffering of that failure. The act must be free of political influence, and the political must recognize its responsibility to ensure that the humanitarian can exist” (Orbinski, 2000). The responsibility for addressing the suffering of humans lies, ultimately, with political systems and countries. The needs for humanitarian organizations exist because these systems either fail to provide adequate interventions and support or are the instigators of human suffering in the first place. “Humanitarianism is not a tool to end war or to create peace. It is a citizens’ response to political failure. It is an immediate, short term act that cannot erase the long-term necessity of political responsibility” (Orbinski, 2000)

Additionally, ”[h]umanitarian action requires a framework in which to act. In conflict, this framework is international humanitarian law. It establishes rights for victims and humanitarian organizations. It fixes the responsibility of states to ensure respect of these rights, and to sanction their violations as war crimes. Today this framework is clearly dysfunctional. Access to victims of conflict is often refused. Humanitarian assistance is even used as a tool of war by belligerents. And more seriously, we are seeing the militarization of humanitarian action by the international community” (Orbinski, 2000).

The speech (Orbinski, 2000) also addresses how language shapes our view. Aside from natural disasters, humanitarian aid is not existing without the responsibility of another for a crime – and usually a crime on a massive scale, which causes significant human suffering. We tend to downplay the roles and responsibilities that actors have when we discuss the situation as a humanitarian emergency, removing it from it’s context.  At the same time, those providing humanitarian aid should refrain from politicizing or allow their preference of who to help rely on which side of a conflict one is on. The speech by MSF acknowledges that their humanitarian work exists within societal, cultural and political contexts, while at the same time working to clarify its purpose and goals outside of such, in terms of human rights and other essential rights, such as environmental ones, and to resist the urge to polarize peoples, systems, and governments as good or bad. As part of maintaining this, MSF remains an independent organization, and resists funding or oversight by any militarized group, which it views as being impossible to remain impartial.

I personally see the standards of MSF (Orbinski, 2000) as being important and applicable to using mental health care in humanitarian aid across diverse settings and peoples. Acknowledging that biases exist, and to choose to work on them in our own personal spaces with peers, mentors, and our own therapists, while aiming to approach each individual that we work with as a human being with an inherent right to dignity, worth, value, and deserving of empathy and care, regardless of their behaviors or actions. This aligns with the principles of Sphere (2018), and can be guides for how to approach care with refugees.

References

Orbinski, J. (2000). There is no such thing as military humanitarianism. Peace Magazine; Winter 2000. Retrieved from http://www.peacemagazine.org/archive/v16n1p08.htm

TEDGlobal (2015). António Guterres: Refugees have the right to be protected. Retrieved from https://www.ted.com/talks/antonio_guterres_refugees_have_the_right_to_be_protected

The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. (2018). Retrieved from https://www.developmentbookshelf.com/doi/book/10.3362/9781908176707. DOI: 10.3362/9781908176707

The Sphere Project (2011). Introducing the Sphere Handbook 2011 . Retrieved from http://www.youtube.com/watch?v=zpXxVg-Cv8A&feature=related.

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